CROHN'S DISEASE WITH RECURRENT MASSIVE LOWER GASTROINTESTINAL HEMORRHAGE
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概要
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Massive lower gastrointestinal hemorrhage is an infrequent complication of Crohn's disease. A 24-year-old man was admitted to our hospital because of loss of appetite and watery diarrhea. On the second hospital day, he developed gross rectal bleeding (approximately 2, 000 ml) without abdominal pain, followed by a syncopal episode. The upper gastrointestinal series revealed no abnormalities. Colonoscopy showed multiple punched-out ulcers and exfoliation of the colonic mucosa sparing the rectum. However, longitudinal ulceration and cobblestoning of the mucosa were not noted. Although it is not always easy to distinguish between Crohn's colitis and severe ulcerative colitis, a double contrast study of the small intestine performed at the time of a third episode disclosed longitudinal ulceration at separated regions of the terminal ileum, and the diagnosis of Crohn's ileocolitis was made. This case is highly unusual in that it involved recurrent episodes of sudden and massive hemorrhage that required blood transfusions. The bleeding was successfully controlled by conservative measures, including steroid therapy.
- 社団法人 日本消化器内視鏡学会の論文
社団法人 日本消化器内視鏡学会 | 論文
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